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It’s been a summer of sport, kicking off with the world cup in Rio and rounding up with the Commonwealth Games hosted here in the UK. Events such as these are capital in inspiring people to take up new sporting activities or, like myself, get back into their fitness regime that may have become a bit too relaxed over the summer season.

The most common form of exercise in which people partake is running, whether it be road running, cross country or in the gym. When running, it is however important to consider wearing the correct footwear, your running style, biomechanics and running surface, all of which can have a detrimental effect if not optimal. There are various sports injuries that are considered common to a runner. Here I will give you a quick rundown of some of the most common running injuries, their symptoms, causes and possible rehabilitation options commonly used by sports therapists and physiotherapists. If you are suffering from an injury, it is recommended that you see a professional who can assess your individual condition and work with you to design a treatment and rehabilitation plan specific to you.

Patella Femoral Pain Syndrome (PFPS) – also more commonly known as “Runners Knee”

This affects the front portion of your knee joint.

Symptoms

  • A dull ache around the knee cap (patella) which worsens when exercising
  • Sharp stabbing pain that eases immediately when exercise is stopped
  • Pain around the patella when walking down stairs or going downhill
  • Possible swelling and clicking around or behind the knee cap

Causes

  • Over use of the patella femoral joint under loads
  • Long distance running
  • Running downhill
  • Incorrect running biomechanics and footwear.
  • Weak inner thigh muscles or tight outer thigh muscles.
  • Patella mal-alignment or patella mal-tracking (altered knee cap orientation and movement in relation to the thigh (femur) bone).

Treatments / rehabilitation options

  • Patella taping
  • Massage therapy
  • Inner thigh strengthening exercises
  • Shoe orthotics
  • Outer thigh flexibility training
  • Knee braces
  • Acupuncture

Plantar Fasciatis

This condition affects the muscles and connective tissue at the soles of the feet.

Symptoms

  • Cramping sensation at the sole of the foot
  • Pain at the inside portion of the heel
  • Crunchy / crepitus feeling when sole of foot is massaged
  • Morning pain that eases with gentle activity
  • Increase in pain during exercise.
  • Cramping and pain easing when the muscles at the sole of the foot are stretched.

Causes

  • High foot arches or flat feet (the plantar fascia has to work harder to support the foot arch correctly under motion and impact)
  • Activities involving lots of high impact forces through the foot in motion (eg: running & dance)
  • Tight gastrognemius and soleus muscles of the calf
  • Incorrect running footwear
  • Running on hard and flat surfaces

Treatment / rehabilitation options

  • Modifying the aggravating activity
  • Self massage, for example rolling a golf ball under the sole of the foot
  • Stretching program
  • Therapy
  • Shoe orthotics / running shoe alteration
  • Acupuncture
  • Therapeutic ultrasound

ITB Friction Syndrome

ITB friction syndrome occurs when the Illio Tibial Band (ITB) that connects the TFL muscle to the tibia bone of the lower leg becomes inflamed.

Symptoms include

  • Pain or dull ache at the outside of the knee joint
  • Pain increasing with running
  • Onset of pain is after same length of time into a course of running
  • Tightness of the outer thigh muscles and gluts.

Causes

  • Long distance running
  • Downhill or cambered running courses
  • Incorrect running footwear
  • Incorrect running biomechanics increasing outside forces at the knee
  • Tight gluts
  • ITB repeatedly moving against the lateral epicondyle of the femur bone
  • Increase in pressures exerted through the outer portion of the knee joint with high impact activities.

Treatment / rehabilitation options

  • Modifying aggravating activities
  • Massage therapy
  • Acupuncture
  • Stretching program
  • Shoe orthotics / changing footwear
  • Therapeutic ultrasound

Achilles Tendinopathy

Like the ITB, The achilles tendon is exposed to high velocities during running. An Achilles tendinopathy is an overuse injury that leads to the degeneration of the Achilles tendon within its tendon sheath. It is important to remember that with an Achilles tendinopathy, pain can range from minor – severe and symptoms can be present from a matter of days to years.

Symptoms include

  • Pain at the posterior ankle in the morning that eases with gentle activity
  • Sudden pain or pain increase with exercise
  • Swelling of the Achilles tendon
  • Reduced range of motion at ankle or altered walking and running gait
  • Tenderness when palpating Achilles tendon.

Causes

  • Change in running footwear, distance, speed or surface
  • Running for a number of years
  • Poor flexibility and / strength of gastrocnemius and soleus muscles
  • Incorrect running footwear
  • Increase in frequency of running sessions
  • Poor running biomechanics.

Treatment / rehabilitation options

  • Calf strength and flexibility exercises
  • Massage therapy
  • Acupuncture
  • Therapeutic Ultrasound
  • Shoe orthotics / change of footwear
  • Biomechanical training
  • Altering running training

Medial Tibial Stress Syndrome

Medial tibial stress syndrome (MTSS) or known by its common (and incorrect) name of shin splints, affects the anterior portion of the lower leg.

Symptoms include

  • Pain up the inner portion of the anterior shin
  • Pain decrease with warming up
  • Increase in pain at shin with high impact movements
  • Tenderness upon palpation of inner shin bone
  • Difficulty easing pain after activity
  • Soreness the day following activity.

Causes

  • Repeated high impact activities for a long duration
  • Tibialis posterior, flexor digitorum longus and / or soleus muscle tightness.
  • Flat feet
  • Reduced muscle flexibility.
  • Hard and flat training surfaces
  • Biomechanical errors
  • Incorrect footwear
  • Reduced bone mineral density.

Treatment / rehabilitation options

  • Massage therapy
  • Therapeutic ultrasound
  • Muscle strengthening and flexibility training
  • Reducing high impact activities (cross training / swimming)
  • Shoe orthotics / change in footwear
  • Biomechanical training

As previously stated, these injuries are common in runners, so don’t worry if you feel you have a couple of niggles that have been mentioned, they are easy to get under control and the team at Capital Physio are more than happy to advise you with any queries that you may have regarding any aches and pains.

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